CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: St Luke's Sugar Land Hospital

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84153
Insurance Median: $39
Cash Discount Price: $127
vs. Medicare Baseline: 2.12x Medicare

The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at St Luke's Sugar Land Hospital is $39. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $127. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 2.12x the Medicare baseline. Located in 1317 Lake Pointe Parkway, Sugar Land, TX.

Cash / Self-Pay

$127

Average discount available for prompt cash payment at this facility.

Insurance Median

$39

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$18.39

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $18.39 (100%)

Cash / Self-Pay: $127 (691%)

Insurance Median: $39 (212%)

Cash: $127 (691% of Medicare)

Ins. Median: $39 (212% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $18.39 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 212% of the Medicare baseline (a markup of 112%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Renaissance	$13	71%
Tchp	$15 - $21	82%
Wellpoint	$15 - $28	82%
Blue Cross Blue Shield	$16 - $94	87%
United	$16 - $170	87%
UnitedHealthcare	$16 - $299	87%
Chc	$18 - $199	98%
Cigna	$18 - $253	98%
Humana	$18 - $235	98%
Selectcare	$18	98%
Aetna	$19 - $246	103%
Amerivantage	$19	103%
Devoted	$20	109%
Kindred	$20	109%
Scanhealth	$20	109%
Kelsey	$23	125%
Kelseycare	$25	136%
Community Health Choice	$28	152%
Superior Health Plan	$28	152%
Bright Health	$30	163%
Nx Health	$60	326%
Tchpchip	$127 - $156	691%
Texastruechoice	$199	1082%
Coventry	$235	1278%
First Health	$235	1278%
Healthsmart	$253	1376%
Interlink	$253	1376%
Multiplan	$272	1479%
USA Health Network	$308	1675%
Mhealth Network	$362	1968%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $127.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 84153.

Insurance In-Network Protection Plan

Contact your insurance company to confirm St Luke's Sugar Land Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 84153.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.